Dr. Todd Morgan

Well, you know, a given PSA can be inaccurate for lots of reasons. We're going to check it again. And, you know, yes, I know there's like there feels like there's got to be urgency to do something. But believe it or not, prostate cancer is still relatively slow, slow growing. We look at all the disease features for that person's cancer, just like you mentioned, what do you factor in?

Well, you know, a given PSA can be inaccurate for lots of reasons. We're going to check it again. And, you know, yes, I know there's like there feels like there's got to be urgency to do something. But believe it or not, prostate cancer is still relatively slow, slow growing. We look at all the disease features for that person's cancer, just like you mentioned, what do you factor in?

Well, you know, a given PSA can be inaccurate for lots of reasons. We're going to check it again. And, you know, yes, I know there's like there feels like there's got to be urgency to do something. But believe it or not, prostate cancer is still relatively slow, slow growing. We look at all the disease features for that person's cancer, just like you mentioned, what do you factor in?

Of course, age overall. health and comorbidities brought, like hopefully if they're a surgical patient, they've got a life expectancy greater than 10 years and all that. And then the cancer features, right? What stage, grade, pre-op PSA, did you have a PSMA PET pre-op or not? And what did it show? So those things are really important. What is their PSA at the time of recurrence?

Of course, age overall. health and comorbidities brought, like hopefully if they're a surgical patient, they've got a life expectancy greater than 10 years and all that. And then the cancer features, right? What stage, grade, pre-op PSA, did you have a PSMA PET pre-op or not? And what did it show? So those things are really important. What is their PSA at the time of recurrence?

Of course, age overall. health and comorbidities brought, like hopefully if they're a surgical patient, they've got a life expectancy greater than 10 years and all that. And then the cancer features, right? What stage, grade, pre-op PSA, did you have a PSMA PET pre-op or not? And what did it show? So those things are really important. What is their PSA at the time of recurrence?

0.2 is a whole lot better than 2.0. And then the timing that like the, what is the distance between the surgery and that time of recurrence? And so that six-week mark, that persistently elevated PSA is a much worse prognostic feature than somebody who has a recurrence five years after surgery, which does happen.

0.2 is a whole lot better than 2.0. And then the timing that like the, what is the distance between the surgery and that time of recurrence? And so that six-week mark, that persistently elevated PSA is a much worse prognostic feature than somebody who has a recurrence five years after surgery, which does happen.

0.2 is a whole lot better than 2.0. And then the timing that like the, what is the distance between the surgery and that time of recurrence? And so that six-week mark, that persistently elevated PSA is a much worse prognostic feature than somebody who has a recurrence five years after surgery, which does happen.

Those patients that have a really late recurrence are at much lower risk of progression. So all those things are important considerations. There is a table in the guideline that lists those key considerations that I just mentioned. I think PSA doubling time is in there too. Genomics can be in there for folks who find genomics to be helpful in their practice. That's kind of the initial framework.

Those patients that have a really late recurrence are at much lower risk of progression. So all those things are important considerations. There is a table in the guideline that lists those key considerations that I just mentioned. I think PSA doubling time is in there too. Genomics can be in there for folks who find genomics to be helpful in their practice. That's kind of the initial framework.

Those patients that have a really late recurrence are at much lower risk of progression. So all those things are important considerations. There is a table in the guideline that lists those key considerations that I just mentioned. I think PSA doubling time is in there too. Genomics can be in there for folks who find genomics to be helpful in their practice. That's kind of the initial framework.

And then we've got to think about, okay, this is a patient who is likely going to need radiation. We're going to confirm their PSA. And then we've got to think about timing because, yeah, radiation does have side effects. And one of the important acts that we think about is kind of as good as a patient's continence gets before radiation is as good as it's going to get.

And then we've got to think about, okay, this is a patient who is likely going to need radiation. We're going to confirm their PSA. And then we've got to think about timing because, yeah, radiation does have side effects. And one of the important acts that we think about is kind of as good as a patient's continence gets before radiation is as good as it's going to get.

And then we've got to think about, okay, this is a patient who is likely going to need radiation. We're going to confirm their PSA. And then we've got to think about timing because, yeah, radiation does have side effects. And one of the important acts that we think about is kind of as good as a patient's continence gets before radiation is as good as it's going to get.

We really want to hold off time. on salvage radiation until ideally the patient has regained continence and it had a chance to fully heal. And hopefully that really reduces the risk of significant urinary complications. Yeah, there are some adverse effects of post-op pelvic radiation. It can cause urinary frequency. It can cause bowel irritation and cause stricture.

We really want to hold off time. on salvage radiation until ideally the patient has regained continence and it had a chance to fully heal. And hopefully that really reduces the risk of significant urinary complications. Yeah, there are some adverse effects of post-op pelvic radiation. It can cause urinary frequency. It can cause bowel irritation and cause stricture.

We really want to hold off time. on salvage radiation until ideally the patient has regained continence and it had a chance to fully heal. And hopefully that really reduces the risk of significant urinary complications. Yeah, there are some adverse effects of post-op pelvic radiation. It can cause urinary frequency. It can cause bowel irritation and cause stricture.

But if you look at the data, they're probably not as bad as we think in our heads as urologists that There's a pretty robust set of data, including from University of Chicago, who's looked at there's a series of patients undergoing salvage radiation. And a lot of the side effects are relatively short-term, and late effects are pretty mild. So I think we think about all those things.

But if you look at the data, they're probably not as bad as we think in our heads as urologists that There's a pretty robust set of data, including from University of Chicago, who's looked at there's a series of patients undergoing salvage radiation. And a lot of the side effects are relatively short-term, and late effects are pretty mild. So I think we think about all those things.